Alliance School of Nursing & Health Sciences
Admission Application Form
Student Information
First Name
Middle Name
Last Name
Date of Birth
Gender
Select Gender
Male
Female
Other
Blood Group
Select Blood Group
A+
A-
B+
B-
AB+
AB-
O+
O-
Nationality
Current Address
City
State
Zip Code
Parent/Guardian Information
Father's Name
Father's Occupation
Father's Phone
Father's Email
Mother's Name
Mother's Occupation
Mother's Phone
Mother's Email
Academic Information
Grade Applying For
Select Grade
Pre-Kindergarten
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12
Current School (if any)
Previous Academic Records
Upload report cards/transcripts from previous school
Extracurricular Activities (check all that apply)
Sports
Music
Arts
Dance
Other (please specify)
Medical Information
Does the student have any of the following? (check all that apply)
Allergies
Asthma
Diabetes
Vision Problems
Hearing Problems
Other (please specify)
Additional Medical Notes
Immunization Records
Upload immunization records
Declaration
I hereby declare that all the information provided in this form is true and correct to the best of my knowledge. I understand that providing false information may result in the cancellation of admission.
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